Psychedelic Therapy: A Primer for Primary Care Clinicians-Historical Perspective and Overview.
Burton J. Tabaac, Kenneth Shinozuka, Alejandro Arenas, Bryce D. Beutler, Kirsten Cherian, Viviana D. Evans, Chelsey Fasano, Owen S. Muir
American Journal of Therapeutics DOI: 10.1097/mjt.0000000000001727 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Randomized Double-blind Peer reviewed |
|---|---|
| Topics | Psychedelic-assisted therapy |
| Keywords | Mental health treatment Clinical research Psychedelics Alternative medicine Therapeutic breakthroughs |
| Citations | 12 |
| Key findings | Psilocybin's remission rate in larger trials is 25%-29%, comparable to the 30% remission rate of antidepressants. |
Abstract
Psychedelic drugs have recently emerged as plausibly effective pharmacological agents for the management of depression, anxiety, and other neuropsychiatric conditions, including those that are treatment-resistent. The latter half of the 20th century marked a revolution in the treatment of mental illnesses, exemplified by the introduction of selective serotonin reuptake inhibitors and other pharmacological agents. Nevertheless, mental illness remains a major public health crisis, affecting nearly one billion individuals worldwide. Because of the decades-long status of several psychedelics as Schedule I drugs, there have not been very many large, double-blind, randomized controlled trials of psychedelics. Owing to small sample sizes, there may be rare yet serious adverse events that have not been reported in the clinical trials thus far. Esketamine, a dissociative hallucinogen drug, was approved for the management of major depressive disorder by the Food and Drug Administration in 2019. As of January 2024, two Phase III trials of 3,4-methylenedioxymethamphetamine (MDMA), a synthetic drug that inhibits the serotonin transporter, have been completed; the results indicate that MDMA is superior to existing pharmacological treatments for post-traumatic stress disorder. A phase III trial of psilocybin, a naturally occurring serotonin receptor partial agonist, is currently underway. The following series details the current state of research in psychedelic therapeutics, including lysergic acid diethylamide (LSD), N-N-dimethyltryptamine (DMT) and ayahuasca, psilocybin, ibogaine, MDMA, and ketamine. While initial clinical trials of psychedelics for depression were very promising, trials of psilocybin with larger sample sizes (100+ participants) suggest that its remission rate is 25%-29%. This is about the same as the remission rate of antidepressants, which is roughly 30% according to the landmark STAR*D trial. Psychedelic drugs and structural derivatives offer a great deal of promise for the management of a wide range of psychiatric morbidities. It is imperative that clinicians become familiar with these novel agents and learn how to integrate psychedelic therapy with the rest of their care through open communication and referral.
Comparable studies
Other narrative reviews on psychedelic-assisted therapy, most cited first.
Citations in the library
Cited by 7
- LSD flattens the hierarchy of directed information flow in fast whole-brain dynamics. Imaging Neuroscience January 3, 2025
- The many faces of psilocybin-related psychosis: A case series Psychiatry Research Case Reports December 7, 2024
- Psilocybin in Older Adults: Therapeutic Opportunities in Inflammation-Driven Disorders of Aging-From Depression to Neurodegeneration. International Journal of Molecular Sciences May 9, 2026
- Psychedelic Therapy: A Primer for Primary Care Clinicians—5-Methoxy-N,N-Dimethyltryptamine American Journal of Therapeutics February 20, 2026
- Examining the influence of team-based learning on medical students’ comprehension and attitudes regarding psychedelic therapies Dialogues in Clinical Neuroscience September 2, 2024
and 2 more in the library
Cites 54
- A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression Archives of General Psychiatry August 1, 2006
- Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Journal of Psychopharmacology November 30, 2016
- Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Journal of Psychopharmacology November 30, 2016
- Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance Psychopharmacology July 7, 2006
- Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. The Lancet Psychiatry May 17, 2016
and 49 more in the library